Health
Alzheimer's drug embrace slows down as US doctors' reluctance grows
Nine months into the U.S. launch of the first drug proven to slow the advance of Alzheimer’s, Eisai and Biogen’s Leqembi is facing an unexpected hurdle to widespread use: an entrenched belief among some doctors that treating the memory-robbing disease is futile.
Alzheimer’s experts had anticipated bottlenecks due to Leqembi’s requirements, which include additional diagnostic tests, twice-monthly infusions and regular brain scans to guard against potentially lethal side effects.
And those issues have played a role in slow adoption since the drug was approved by the U.S. Food and Drug Administration, according to interviews with 20 neurologists and geriatricians from rural, urban, academic and community practices in 19 states.
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In interviews with Reuters, seven doctors treating patients for Alzheimer’s attributed their own reluctance to prescribe Leqembi to concerns about the drug’s efficacy, cost and risks.
The use of the FDA-approved Alzheimer’s drug, Leqembi, has slowed down as doctor’s skepticism increases, while patients like Lyn Castellano in St. Louis continue to use the drug as it offers a sense of hope for her future. (Joe Castellano/Handout via REUTERS)
“I don’t think it’s a good Alzheimer’s drug. I think that’s the problem,” said Dr. James Burke, a neurologist at the Ohio State University who has been an outspoken critic of Leqembi. “It’s certainly nothing like the home run that we’re looking for.”
Another six scientists, all leaders in the field, said “therapeutic nihilism” – the belief that Alzheimer’s is a hopelessly intractable disease – was playing a bigger role than anticipated in suppressing demand from primary care doctors, geriatricians and neurologists who could be sending patients to memory specialists for treatment.
Dr. Reisa Sperling, a neurologist and Alzheimer’s researcher at Mass General Brigham in Boston, likens some doctors’ skepticism to Leqembi to fatalistic attitudes about cancer treatment 30 years ago: “You can’t really do anything about it, so why would you even want to get tested?”
Alex Scott, Eisai’s chief administrative officer, acknowledged that skepticism has weighed on the launch along with slower-than-expected adoption by large health systems.
He suggested that some of the doctors’ hesitancy could be a holdover from the decades-long journey to prove that removing the Alzheimer’s protein beta amyloid from the brain could slow the course of the disease. Before Esai released the promising results of its Leqembi trial, some thought that area of research “a fool’s errand,” Scott said.
“We are beginning to make more and more progress every single month. So we’re still quite encouraged,” Scott said. “This is a new journey, and I think it takes some time for providers to figure it out.”
‘SIGNIFICANT RISKS, MARGINAL BENEFIT’
Leqembi was the first amyloid-targeting drug granted full FDA approval after it slowed the decline in cognition in people in the early stages of Alzheimer’s by 27% in a clinical trial.
Of the 10,000 Americans the companies hoped to treat by the end of March, Eisai announced only a couple thousand had begun treatment as of the end of January. An Eisai spokeswoman declined to provide updated numbers.
Even for treatments that do not require dramatic changes to medical practice, adoption of new drugs is notoriously slow. Several studies have estimated that it can take 17 years on average for clinical research to be translated into routine practice.
The disease is estimated to affect more than 6 million Americans, according to the Alzheimer’s Association.
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Fewer than half of U.S. neurologists recommend Leqembi to patients, according to a January survey by life sciences market researcher Spherix Global Insights.
Dr. Michael Greicius, a professor at Stanford University’s Center for Memory Disorders, said there is little evidence that Leqembi benefits patients in a meaningful way.
“If we take the trial result at face value, the differences between placebo and treatment are likely small enough as to be undetectable by patients and family members or physicians,” said Greicius, who does not recommend Leqembi to patients.
He said the long wait for an Alzheimer’s drug has put doctors in the position of feeling obligated to offer a treatment “even if the evidence for it is very slim.”
Other doctors have raised concerns about the risk of brain swelling and bleeding associated with Leqembi as well as the costs associated with the $26,500 annual drug, frequent MRIs and twice-monthly infusions.
“There are significant risks associated with these drugs, there are significant costs, and I would say there is marginal benefit,” said Dr. Eric Widera, a geriatrician and professor at University of California San Francisco, referring to amyloid-lowering treatments.
In an editorial published in November in the Journal of Gerontological Nursing, Donna Fick, president of the American Geriatrics Society, advised doctors that the group recommends caution in the use of lecanemab, which is sold under the brand name of Leqembi.
“It is not yet clear whether treatments such as lecanemab that remove amyloid from the brain produce clinically important slowing of cognitive decline in Alzheimer’s disease.”
‘YOUR ENEMY IS NIHILISM’
Dr. Jonathan Liss, a neurologist from Columbus, Georgia, who serves on Eisai’s scientific advisory board and has tested Leqembi in clinical trials, said he first warned about nihilism at a November 2022 conference following a presentation of Leqembi’s breakthrough study.
Eisai had asked its scientific advisors how the drug might fare against future rivals. Liss cautioned that rivals were not the enemy; “your enemy is nihilism,’” he recalled. “All of the neurologists around the table started applauding.”
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Dr. Nathaniel Chin, a geriatrician with the University of Wisconsin’s Alzheimer’s Disease Research Center, said he was the target of negative comments on social media after he urged geriatricians to embrace such treatments in the Journal of the American Geriatrics Society.
Geriatricians, geriatric social workers and nurses objected, arguing that the drug’s statistically significant benefit was not clinically meaningful to patients, especially given the risks, he said.
“I would ask the question, ‘Is it ethical to withhold a medication that is FDA-approved and covered by insurance from someone who knows the risk and is willing to take it?’” Chin said.
Dr. Priya Singhal, executive vice president and head of development at Biogen, acknowledged some apathy among physicians about the treatment but said that infrastructure and lack of access to neurologists have been bigger issues.
Singhal said the companies are working with physician and patient advocacy groups and developing educational programs and materials aimed at diagnosing early-stage patients, managing side effects and understanding the drug’s benefits.
The companies said they intend to increase their salesforce by 30% as they aim for 100,000 patients by 2026.
For the moment, Leqembi is the only Alzheimer’s drug on the market designed to slow the course of the disease. A decision on Lilly’s donanemab has been delayed until the FDA convenes an advisory panel.
Lilly neuroscience president Anne White said in an interview that she sees doctor hesitancy as an issue that the company hopes to address by making clear which patients benefit from such treatments.
In the early stages of Alzheimer’s, many patients are still independent, and to be able to remain so for longer is very meaningful, she said.
‘PEACE AND QUIET’
Lyn Castellano, 64, who founded and ran a St. Louis breast cancer charity for 20 years and trained therapy dogs, started taking Leqembi last September, nearly a year after she found herself struggling with keeping track of appointments and was diagnosed with mild cognitive impairment.
Castellano said the prospect of bleeding in the brain – a possible side effect of the drug – was her biggest concern, but her family believed the drug may offer a chance at slowing the disease.
She is one of more than 140 patients being treated by physicians from Washington University in St. Louis, and has had 13 infusions and two MRIs without incident.
Dr. Suzanne Schindler, an Alzheimer’s researcher who is treating Castellano, said Leqembi “forces clinicians to completely change the way they have practiced medicine for many years.”
She said she is candid about Leqembi’s modest benefit as well as the risks. About 80% of those she believes are good candidates have opted for the treatment, she said.
While Castellano can’t tell if Leqembi is helping, she says the treatment has given her hope, and she doesn’t mind the twice monthly infusions.
“I get to go, sit back in a nice chair, have my dog with me and read a book for a couple hours. It’s about the only place I get some peace and quiet.”
Health
4 Mistakes People Make When Starting a GLP-1 That Can Stall Weight Loss—Plus How to Maximize Your Results
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With an aggressive new strain spreading across the country, this year’s flu season has been marked by record-high hospitalizations and reportedly intense symptoms.
As people look for ways to contain the spread, new research has found that a few simple factors can greatly reduce transmission.
Researchers from the University of Maryland Schools of Public Health and Engineering in College Park and the School of Medicine in Baltimore studied influenza spread by placing flu-positive college students in a hotel room with healthy middle-aged adult volunteers.
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The study, published in the journal PLOS Pathogens, is reportedly the first clinical trial investigating how the flu spreads from naturally infected people to uninfected people, according to a press release.
The participants, including 11 healthy volunteers, lived on a quarantined floor of a Baltimore-area hotel for two weeks. During that time, they simulated interactions, including having conversations, doing physical activities like yoga, and passing around objects like pens and tablets from infected people to the rest of the group.
New research has experts questioning how the flu spreads through airborne transmission. (iStock)
Researchers monitored the participant’s symptoms, performed daily nasal swabs, and collected saliva and blood samples to test for antibodies, the release stated.
The study also measured the “viral exposure” in the volunteers’ breathing air and ambient air in the activity room. The exhaled breath of the participants was measured by a machine called the Gesundheit II, invented by researcher Dr. Donald Milton and colleagues at Harvard T.H. Chan School of Public Health.
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At the end of the experiment, none of the healthy individuals had become infected with the flu due to a variety of factors. This included a lack of coughing, as the infected students were holding “a lot of virus in their noses” and only small amounts were “expelled into the air,” the researchers noted.
Researchers said proper ventilation was a major factor in halting flu spread in this study. (iStock)
“Our data suggests key things that increase the likelihood of flu transmission — coughing is a major one,” Dr. Jianyu Lai, post-doctoral research scientist and the study’s lead data analyst and report writer, shared in a statement.
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The other factor was ventilation and air movement, as the air in the study room was “continually mixed rapidly by a heater and dehumidifier, and so the small amounts of virus in the air were diluted,” Lai pointed out.
The researcher added that middle-aged adults are “usually less susceptible” to influenza than younger adults.
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Most researchers assume that airborne transmission is a major factor of disease spread, according to Dr. Donald Milton, professor at SPH’s Department of Global, Environmental and Occupational Health and a global infectious disease aerobiology expert.
“At this time of year, it seems like everyone is catching the flu virus, and yet our study showed no transmission,” he said in the same press release. “What does this say about how flu spreads and how to stop outbreaks?”
There have been 81,000 flu-related hospitalizations and more than 3,000 deaths in the U.S. this year so far, data shows. (iStock)
Milton, who was reportedly among the first experts to identify how to stop the spread of COVID-19, noted that findings from these types of trials are essential to updating international infection-control guidelines.
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“Being up close, face-to-face with other people indoors where the air isn’t moving much, seems to be the most risky thing — and it’s something we all tend to do a lot,” he said.
“At this time of year, it seems like everyone is catching the flu virus, and yet our study showed no transmission.”
“Our results suggest that portable air purifiers that stir up the air, as well as clean it, could be a big help,” Milton suggested. “But if you are really close and someone is coughing, the best way to stay safe is to wear a mask, especially the N95.”
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Approximately 11 million flu illnesses and about 5,000 deaths have occurred so far in the 2025-2026 influenza season, according to CDC data. A large share of the current flu cases are caused by the new influenza A subclade K variant.
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GLP-1 has become a popular buzzword in the weight-loss community — but now some are touting “GLP-3s,” claiming they are taking obesity medications to the next level.
GLP-1 (glucagon-like peptide-1) medications work by mimicking a naturally occurring hormone in the body that helps regulate blood sugar and appetite.
The informal term “GLP-3” refers to a new triple-agonist drug that targets three hormones: GLP-1, GIP (glucose-dependent insulinotropic polypeptide, another naturally occurring hormone released by the gut after eating) and glucagon receptors. The most advanced example is retatrutide by Eli Lilly, according to clinical trial outcomes.
OBESITY EXPERT REVEALS THE BEST WAY TO DECIDE IF GLP-1S ARE RIGHT FOR YOU
The New England Journal of Medicine published results from a 2023 phase 2 retatrutide trial for obesity, revealing “substantial reductions in body weight” after 48 weeks of treatment.
A 12 mg once-weekly injection led to a 24.2% weight reduction, and participants continued to drop pounds after the 48-week trial period.
GLP-1 (glucagon-like peptide-1) medications work by mimicking a naturally occurring hormone in the body that helps regulate blood sugar and appetite. (iStock)
Side effects were reportedly similar to GLP-1 medications, most commonly including gastrointestinal complications like nausea, vomiting and diarrhea. Heart rate increases were noted, depending on the dose.
How it’s different
Retatrutide mimics three natural hormones found in the body, compared to GLP-1s that simulate just one hormone, according to a report by GoodRx pharmacists.
GIP and GLP-1 hormones signal the pancreas to release insulin after eating, while slowing digestion to help initiate feelings of fullness.
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These hormones target the area of the brain that regulates appetite and influences food cravings, the report noted.
The third hormone, glucagon, speeds up metabolism and helps the body break down fat cells for energy. That hormone also tells the liver to make new sugar, which is kept in check by GIP and GLP-1 activity, preventing blood sugar spikes.
Participants in the phase 3 trial saw an average weight loss of 71.8 pounds. (iStock)
“This added metabolism boost can add to and complement GIP’s and GLP-1’s actions. And that’s why it seems to provide significant weight loss,” the GoodRx website states. “If approved, retatrutide will be the first in a new class of medications.”
Eli Lilly announced results from its phase 3 trial TRIUMPH-4 in December, testing retatrutide’s effect on weight loss and other health conditions.
“We believe retatrutide could become an important option for patients with significant weight loss needs and certain complications.”
Participants with obesity and knee arthritis who took a 12-mg dose of retatrutide saw an average weight loss of 71.8 lbs (28.7%) at 68 weeks.
“For retatrutide, the findings from TRIUMPH-4 are encouraging, and with seven additional phase 3 readouts expected in 2026, we believe retatrutide could become an important option for patients with significant weight loss needs and certain complications, including knee osteoarthritis,” a Lilly spokesperson said in a statement to Fox News Digital.
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The drug also reduced Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain scores by an average of 75.8%, marking “significant improvements” in comfort level and physical function.
More than one in eight patients reported being “completely free” from knee pain at the end of the trial, according to a press release from Lilly.
Participants with obesity and knee arthritis who took a 12-mg dose of retatrutide saw an average weight loss of 71.8 lbs (28.7%) at 68 weeks. (iStock)
Seven additional phase 3 trials for retatrutide are expected to wrap up in 2026. The drug could see FDA approval in 2027, according to GoodRx.
The Lilly spokesperson noted that there have been no studies comparing retatrutide to GLP-1 treatments due to “differences in study design and patient populations.”
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Despite limited data availability on the drug, the medication could also be applied to treat other conditions like type 2 diabetes, kidney disease, cardiovascular risk reduction and metabolic dysfunction, according to GoodRx and other experts.
Fox News senior medical analyst Dr. Marc Siegel noted that Lilly’s Zepbound and Mounjaro already target two metabolic pathways — GLP-1 and GIP — which work together to promote weight loss, reduce hunger and inflammation, improve insulin function and slow digestion.
The doctor confirmed that the new drug, with its third receptor agonist, will further decrease hunger while increasing the feeling of fullness.
More than one in eight patients reported being “completely free” from knee pain at the end of the trial. (iStock)
“The weight loss in clinical trials is even more substantial, and the most likely reason that it decreases orthopedic problems is because of the weight loss — less stress on the joints and the decreased inflammation,” Siegel added.
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The most common side effect of GLP-3s is gastrointestinal symptoms, the doctor confirmed. Rarer side effects may include pancreatitis, gallstones and heart arrhythmia.
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Philip Rabito, M.D., a specialist in endocrinology, weight loss and wellness in New York City, shared in an interview with Fox News Digital that this new class of weight-loss drugs is positioned to “approach bariatric surgery level outcomes” — although it doesn’t come without risks.
“The novel glucagon‑agonist component introduces less‑understood long‑term safety considerations, so it is imperative that patients are followed closely by healthcare professionals experienced with this class of medicines, with cautious, stepwise use, despite the impressive efficacy,” he cautioned.
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